CASE REPORT DELAYED PROGRESSION AND INEFFICIENT TRANSMISSION OF HIV-2

Abstract. We report a case of HIV-2 infection with delayed progression, taking approximately one and a half decades to develop HIV related symptoms. The spouse was still negative for HIV with a history of having regular unprotected sex with the index case which highlights the inefficient transmissibility of HIV-2. Continued surveillance is needed in screening of HIV-2 infection, especially in cases with a high index of suspicion and risk factors for HIV-2, as these patients develop AIDS related symptoms quite late due to delayed progression

A case of bilateral empyema with pericardial effusion caused by streptococcus intermedius in an immunocompetent patient

Streptococcus intermedius, a member of the Streptococcus anginosus group and a part of the human oropharyngeal microbiome, is a recognised pathogen, mostly in immunocompromised patients or post gastrointestinal surgery, known to cause suppurative metastatic abscesses. We present an unusual case of bilateral empyema with pericardial effusion caused by Streptococcus intermedius in a healthy 30-year-old adult male patient with no known predisposing factors.This case report illustrates the ability of S. intermedius to produce life-threatening empyema in a healthy adult without any predisposing factors

Utility of Serum Neopterin and Serum IL-2 Receptor Levels to Predict Absolute CD4 T Lymphocyte Count in HIV Infected Cases

A prospective study was carried out to evaluate the efficacy of serum neopterin and soluble IL-2 receptor (sIL-2R) concentrations in comparison to CD4 count to study the progression of HIV disease and monitor response to ART in HIV cases. One hundred newly diagnosed HIV seropositive subjects were recruited. CD4 counts were determined by FACS system. Serum neopterin and sIL-2R levels were measured using enzyme immunoassay. In our study, levels of neopterin and sIL-2R were significantly higher in subjects with CD4 <200 cells/μL (with S. neopterin levels of >25.1 nmol/L and sIL-2R levels of >47.1 pM as cutoff values for CD4 <200 cells/μL) compared to those in subjects with CD4 >200 cells/μL at baseline which indicate that these markers can be utilized for initiation of ART in HIV cases. The levels of these markers decreased significantly after initiation of ART. In patients with CD4 >200 cells/μL, these markers are helpful in predicting disease progression

Dynamics of complete and incomplete fusion of

The dynamics of complete and incomplete fusion of 6,7Li, 15N and 16O with a common target (209Bi) around the Coulomb barrier are analyzed within the context of the coupled channel formulation and the energy dependent Woods-Saxon potential (EDWSP) model. The calculated results are compared with experimental fusion cross-sections and it has been shown that complete fusion (CF) data of weakly bound projectile with a heavy target (209Bi) gets suppressed at above barrier energies. In the case of the 6Li + 209Bi (7Li + 209Bi) reaction, the CF data at above barrier energies is reduced by 34% (26%) with reference to the expectations of the coupled channel approach. However, the theoretical estimations due to the EDWSP model can minimize the suppression factor by 9% with respect to the reported value and consequently the portion of above barrier CF cross-section data of 6Li + 209Bi (7Li + 209Bi) reaction is suppressed by 25% (17%) when compared with the present model calculations. This fusion inhibition can be correlated with the low breakup threshold of projectile which in turn breaks up into two fragments in the entrance channel prior to fusion barrier. The total fusion (TF) data, which is sum of complete fusion (CF) data and incomplete fusion (ICF) data, is not suppressed when compared with the predictions of the theoretical approaches and thus breakup channel has very little influence on the total fusion cross-sections. Although the breakup fragments appeared in both reactions, the enhanced suppression effects observed for the lighter projectile can be correlated with its low binding energy associated with the $\alpha$-breakup channel. Further the outcomes of the EDWSP model reasonably explained the ICF contribution appeared in the fusion of 6,7Li + 209Bi reactions. In contrast to this, the observed fusion dynamics of 15N + 209Bi and 16O + 209Bi reactions, wherein the collective excitations such as two phonon, three phonon vibrational states contribute to produce below barrier fusion enhancement, has been adequately explored by the adopted models, and henceforth ensures the stability of well bound nuclei against breakup effects

Tuberculosis as an Etiological Factor in Liver Abscess in Adults

Background. Tuberculosis of the liver without active pulmonary or miliary tuberculosis is considered as an uncommon diagnosis. The aim of the present study was to determine the etiological role of tuberculosis in adult patients presenting with features of liver abscess. Methods. A total of 40 patients with liver abscess were included in the study. The liver abscess aspirate was subjected to microscopy, culture, and polymerase chain reaction to determine the role of tuberculosis as an etiological factor in liver abscess. Results. Of the 40 patients enrolled, 25% (10/40) were diagnosed with having tubercular liver abscess. In a total of 40 specimens, 2.5% (1/40) were positive for acid fast bacilli by Ziehl-Neelsen method, while 10% (4/40) were positive for M. tuberculosis by culture using BACTEC 460 and the yield increased to 25% (10/40) by polymerase chain reaction for M. tuberculosis. Conclusion. 25% of the patients presenting with liver abscess had tubercular etiology without features of active pulmonary or miliary tuberculosis. Liver can act as the primary site of involvement in the absence of activity elsewhere in the body. Tuberculosis should be considered as an important differential diagnosis of liver abscess irrespective of evidence of active tuberculosis elsewhere in the body

Genome profiling of uropathogenic E. coli from strictly defined community-acquired UTI in paediatric patients: a multicentric study

Abstract Background Urinary tract infection (UTI) in children is a common bacterial infection. The emergence of extended-spectrum beta-lactamases (ESBLs) poses a major challenge against the treatment of uropathogens. We aimed to characterize the E. coli isolates recovered from children with UTI for their resistance profile and circulating sequence types (ST). Methods Children (> 1.5–18 years of age) from different community health centres of India with symptoms of UTI were enrolled. Isolates causing significant bacteriuria were identified by Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) and tested for antimicrobial susceptibility by the automated system, VITEK-2 (Biomeriux, Durhum, US). Nineteen E. coli isolates (15 ESBL positive and 4 ESBL negative) were sequenced in Oxford Nanopore platform followed by core-genome phylogeny, accessory genome cluster analysis, identification of sequence types, mobile genetic elements, genetic antimicrobial resistance markers. The correlation between detection of antimicrobial resistance genes with phenotypic resistance profiles was also investigated. Results Eleven percent of children had significant bacteriuria [male:female—1:1, > 50% were 11–18 years of age group]. E. coli was predominant (86%) followed by K. pneumoniae (11%). Susceptibility of E. coli was highest against fosfomycin (100%) followed by carbapenems (90.7%) and nitrofurantoin (88.8%). ST131 (15.8%) and ST167 (10.5%) found as high-risk clones with the presence of plasmid [IncFIB (63.1%), IncFIA (52.6%)], and composite transposon [Tn2680 (46.6%)] in many isolates. Few isolates coharboured multiple beta-lactamases including bla NDM-5 (33.3%), bla OXA-1 (53.3%), bla CTX-M-15 (60%) and bla TEM-4 (60%). Conclusions This study highlights horizontal transmission of resistance genes and plasmids in paediatric patients at community centers across the nation harbouring multidrug-resistant genes such as bla NDM-5 and bla CTX-M-15 associated with high-risk clones ST131 and ST167. The data is alarming and emphasizes the need for rapid identification of resistance markers to reduce the spread in community. To our knowledge, this is the first multicentric study targeting paediatric UTI patients from the community setting of India

Demographic characteristics of enrolled infants.

<p>Demographic characteristics of enrolled infants.</p